title: Global position sensing and step activity as outcome measures of community mobility and social interaction for an individual with a transfemoral amputation due to dysvascular disease.
abstract: OBJECTIVE
  Community mobility of individuals following lower limb amputation is highly variable and has a great impact on their quality of life. Currently, clinical assessments of ambulatory ability and motivation influence prosthetic prescription. However, these outcome measures do not effectively quantify community mobility (ie, mobility outside of the clinic) of individuals with an amputation. Advances in global positioning systems (GPSs) and other wearable step-monitoring devices allow for objective, quantifiable measurement of community mobility. This case report will examine the combined use of a GPS unit and a step activity monitor to quantify community mobility and social interaction of an individual with transfemoral amputation due to dysvascular disease.
  
  
  METHODS
  A 76-year-old woman with a unilateral transfemoral amputation due to vascular disease carried a commercial GPS unit and step activity monitor to quantify her community mobility and social interaction every day over a period of 1 month. The step activity monitor was affixed to her prosthesis. The patient used a wheelchair as well as her prosthesis for everyday mobility.
  
  
  RESULTS
  Information from the GPS unit and step activity monitor provided quantitative details on the patient's steps taken in and out of the home, wheelchair use, prosthesis use, driving trips, and time spent on social and community trips.
  
  
  CONCLUSIONS
  This case report describes a potential clinical measurement procedure for quantifying community mobility and social interaction of an individual with lower limb amputation. Future efforts are needed to validate this measurement tool on large sample sizes and in individuals with different mobility levels. Additionally, automatization of data analysis and technological approaches to reduce compromised GPS signals may eventually lead to a practical, clinically useful tool.
authors.affiliation: A. Jayaraman, PT, PhD, Max Nader Center for Rehabilitation Technologies and Outcomes Research and Center for Bionic Medicine, Rehabilitation Institute of Chicago, and Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois. Mailing address: Max Nader Center for Rehabilitation Technologies and Outcomes Research, Rehabilitation Institute of Chicago, 345 E Superior St, Room 1771, Chicago, IL 60611 (USA).
authors.forename: Arun
authors.initials: A
authors.lastname: Jayaraman
authors.forename: Sean
authors.initials: S
authors.lastname: Deeny
authors.forename: Yochai
authors.initials: Y
authors.lastname: Eisenberg
authors.forename: Gayatri
authors.initials: G
authors.lastname: Mathur
authors.forename: Todd
authors.initials: T
authors.lastname: Kuiken
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000523:psychology / Q000534:rehabilitation*; D001186:Artificial Limbs; D001336:Automobiles; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D007398:Interpersonal Relations; D007866:Leg / Q000601:surgery; D017063:Outcome Assessment, Health Care / Q000379:methods*; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D058992:Social Participation; D016138:Walking; D014910:Wheelchairs